Young E J, Hirsh D D, Fainstein V, Williams T W
Am Rev Respir Dis. 1980 Apr;121(4):743-7. doi: 10.1164/arrd.1980.121.4.743.
Pleural effusions due to Cryptococcus neoformans occurred in 2 patients, 1 with localized pulmonary infection and 1 with disseminated cryptococcosis. Cryptococcal antigen was present in the pleural fluid from both patients and it was present also in the serum and cerebrospinal fluid of the patient with disseminated infection. The cryptococcal antigen test is a sensitive and specific indicator of cryptococcoal infection, and it was not positive in pleural fluid samples from a variety of other conditions including bacterial and mycobacterial infections and primary or metastatic malignancies. Twenty-eight additional cases of cryptococcal pleural effusions have been reported in the English literature, equally divided between patients with infection localized to the thorax and those with disseminated disease. Cryptococcal infection must be considered in the differential diagnosis of patiients with pleural effusion, especially patients with serious underlying diseases treated with corticosteroids. The cryptococcal antigen test appears to be a useful adjunct in diagnosis, and serial determinations may be helpful in assessing response to treatment.
2例患者发生新型隐球菌所致胸腔积液，1例为局限性肺部感染，1例为播散性隐球菌病。2例患者胸腔积液中均存在隐球菌抗原，播散性感染患者的血清和脑脊液中也存在该抗原。隐球菌抗原检测是隐球菌感染的敏感且特异指标，在包括细菌和分枝杆菌感染以及原发性或转移性恶性肿瘤等多种其他情况的胸腔积液样本中均未呈阳性。英文文献中另有28例隐球菌性胸腔积液的报道，胸腔局部感染患者和播散性疾病患者各占一半。胸腔积液患者，尤其是接受皮质类固醇治疗的严重基础疾病患者，鉴别诊断时必须考虑隐球菌感染。隐球菌抗原检测似乎是诊断的有用辅助手段，连续检测可能有助于评估治疗反应。
